Inadvertent left aorto-coronary dissection following percutaneous coronary intervention treated successfully by bail-out left main coronary artery stenting

Left main coronary artery (LMCA) dissection occurs very rarely following percutaneous coronary intervention (PCI). It caused major consequences with no flow in coronary artery and requires immediate surgical or percutaneous intervention. We are reporting a case of 42-year-male patient who presented with effort angina. Coronary angiogram revealed significant stenosis in left anterior descending (LAD) and left circumflex (LCX) coronary artery. During removal of angioplasty balloon and guide wire after successfully stenting in LAD and balloon angioplasty in LCX, guiding catheter induced dissection of LMCA was happened. Subsequently, LMCA was stented; kissing balloon dilatation was done at carina & TIMI III flow re-established.